Md. Naval Hospital Staff Reports 'Fatigue'

A doctor at the National Naval Medical Center yesterday warned a Pentagon review panel that medical staff at the Bethesda hospital are overworked and suffering from "compassion fatigue."

Even as relatives of injured Marines universally praised the medical care and treatment of families in Bethesda, the doctor and several other current and former employees spoke of problems with the workload, maintenance and facilities at the sprawling complex.

The testimony came at a hearing before the Pentagon's independent review group, appointed last month by Defense Secretary Robert M. Gates to look into rehabilitative care for injured service members. Although the focus has largely been on Walter Reed Army Medical Center, Gates ordered the naval hospital be included in the review to fully gauge treatment in the Washington region.

Lt. Cmdr. Brandt E. Rice, a family medicine practitioner at the naval hospital, testified that doctors are saddled with too many administrative duties, lack enough time to devote to patients and face bureaucratic hassles. "My vocalness about this need has been met by some degree of resistance and also retaliation," Rice said.

Ursula Henry, a former Navy worker at the hospital, said some staff members have been "so frustrated with the whole scenario that they left to go across the street" to work at the National Institutes of Health.

Karen Piles, who has worked in the facilities management department at the hospital for 28 years, testified that maintenance has grown dramatically worse in the two years since the Navy switched from public employees to a private contractor, a decision she described as a "disaster."

Piles said there are operating rooms where temperatures are too hot or too cold, in addition to plumbing problems, floods and leaks. "We have struggled for two years with a contractor who can't keep up," she said.

Sandra Bonifant, a research coordinator for a private foundation that works with Vietnam War veterans, complained of an effort to get a handrail installed to help disabled veterans go up steps into a building on the hospital campus. "We were strong-armed into letting it drop," she testified. A hospital spokesman said the handrail was not installed because the building is used for administrative purposes.

After the hearing, panel members said they were struck by contrasts with the testimony heard the previous day at Walter Reed.

A number of speakers at the Army hospital praised the medical care, but many witnesses told of problems with outpatient care and lack of support given to family members. No such complaints were heard at Bethesda.

"It's been harder at Walter Reed, and we think it's a major issue of resources, where the institution has been literally overwhelmed," said panel member James Bacchus, a former Democratic congressman from Florida.

No Walter Reed staff members volunteered to testify during Tuesday's hearing. "We really need to understand that difference," Charles Roadman, a retired Air Force lieutenant general and panel member, said of the contrast to the Bethesda hospital hearing.